Purpose . This study’s objective is to document which factors are associated with binge drinking behaviour in a population-based sample of Canadian youth aged 12 to 14. Middle school is a key period in which binge drinking behaviour is initiated. Binge drinking is an important risk factor for alcohol-related injuries, accidental death, unsafe sexual behaviour, and substance abuse problems. Understanding the drinking patterns of this population can serve to better inform prevention programs and interventions targeted to middle school youth. Methods . This study was based on a secondary analysis of a regionally representative community-based sample drawn from the 2005 Canadian Community Health Survey (CCHS) cycle 3.1. Crude and adjusted logistic regression analyses of binge drinking were conducted using the 6,172 respondents aged 12 to 14 in the sample. Results . Approximately one in every twenty-five 12-to-14-year-olds had binged in the past year. The odds of binge drinking were higher among Whites, poorer adolescents, those with several chronic health conditions, and those with mood disorders. Neither sex, immigrant status, nor self-rated health was significantly associated with binge drinking in either the adjusted or the unadjusted analyses. Conclusions . These findings underline the importance of binge drinking as a public health issue for middle school adolescents.
Introduction . In the African culture, the primary reason for marriage is procreation. Every female strives to perform this role irrespective of her health status so as to fulfill part of the conditions for maintaining the marriage. The question is, to what extent are HIV-positive women aware of the risks of fulfilling this role? The study aimed to determine the reproductive intentions of HIV-positive women in Abia State. Materials and Methods . This was a longitudinal cross-sectional descriptive study conducted among married HIV-positive women attending the Heart to Heart treatment centre in Abia State University Teaching Hospital from February to October 2013. Systematic sampling was used to select 250 married women between the ages of 15–49 years who are on antiretroviral therapy. Interviewer administered questionnaire and focus group discussion were used to obtain relevant information from the participants. Data were analysed qualitatively and quantitatively. SPSS version 17 software was also used in the analyses. Results . The mean number of living children of the respondents was 2.3 ± 4.7. A good proportion of the respondents, 158 (63.7%) the desired to have more children. The younger the age group of the respondents (OR = 7.33), the lower their parity (OR = 3.69) and more regular they attended ARV clinic (OR = 47.76) the more they desired to have more children. The main reason for desiring more children was the quest to have male children. In the words of one respondent, “without a male child, the marriage is not secure. The woman can be chased out at any time.” Conclusion . The fact that a large proportion of HIV-positive women, irrespective of the mean number of living children and their gender, still desired to have more children shows poor knowledge of the risk they are exposed to by having large number of children. Family counseling/education on the benefits of using family planning devices especially condom is necessary for HIV-positive women and their male partners.
Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this study. We found commonalities among all of the cultural/ethnic groups in their experiences of the difficulties of caregiving. However, there were some significant differences in the cultural values and norms that shaped the caregiving experience. We categorized these differences as: (a) cultural embeddedness of caregiving, (b) cultural determinants of caregiving responsibilities or taxonomy of caregiving, and (c) cultural values and norms underlying the decision to provide care. The significance of this study is that it highlights the culturally perceived mandate to provide care in the African, Asian, and Hispanic American cultures.
Introduction. Iran is confronted with increasing trend of divorce in recent decades. Considering the probable role of sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently decided to enrich the educational content of the premarital education programmes. The aim of this study was to compare the effectiveness of the new program with the classic one. Methods. Three hundred fifty-one women were divided into two premarital education groups: classic education (n=162) and new education (n=189). The mental health, quality of life, marital satisfaction, and sexual satisfaction of women were evaluated one year after marriage. Results. At one-year followup, both groups showed improvement in mental health (P<0.001); however physical health-related quality of life decreased in both groups. The two groups showed no significant difference in terms of sexual satisfaction and marital satisfaction. Marital satisfaction showed significant correlation with sexual satisfaction (r=0.55, P<0.001). Conclusion. The new program of premarital education showed no superiority over the classic method. Considering the increasing rate of divorce in Iran, the premarital education programmes may not be successful in achieving their goals. Revision of the premarital education programme is warranted.
Community Home-Based Care (CHBC) has evolved in resource-limited settings to fill the unmet needs of people living with HIV/AIDS (PLHA). We compare HIV and tuberculosis (TB) outcomes from the Nsambya CHBC with national averages in Kampala, Uganda. This retrospective observational study compared HIV and TB outcomes from adults and children in the Nsambya CHBC to national averages from 2007 to 2011. Outcomes included numbers of HIV and TB patients enrolled into care, retention, loss to follow-up (LTFU), and mortality among patients on antiretroviral therapy (ART) at 12 months from initiation; new smear-positive TB cure and defaulter rates; and proportion of TB patients tested for HIV. Chi-square test and trends analyses were used to compare outcomes from Nsambya CHBC with national averages. By 2011, approximately 14,000 PLHA had been enrolled in the Nsambya CHBC, and about 4,000 new cases of TB were detected and managed over the study period. Overall, retention and LTFU of ART patients 12 months after initiation, proportion of TB patients tested for HIV, and cure rates for new smear-positive TB scored higher in the Nsambya CHBC compared to national averages. The findings show that Nsambya CHBC complements national HIV and TB management and results in more positive outcomes.
Objective. To assess medical and nursing students’ knowledge, attitudes, and practices (KAP) regarding human immunodeficiency virus (HIV) in Fiji. Methods. A cross-sectional study of 275 medical and 252 nursing students that participated in a questionnaire survey on HIV KAP. Data was analysed according to their gender, program of study, and academic year. Results. The mean HIV knowledge (HK) and attitude scores were 16.0 and 41.3, respectively. Mean HK score was significantly higher in males compared to females. Significant positive correlations were found between HK and academic year for medical (R=0.459) and nursing (R=0.342) students and between HK and attitude scores (R=0.196). The majority of students indicated fear in contracting HIV through clinical practice and felt that health care workers have the right to know a patients HIV status for their own safety. The majority would wear gloves to touch a patient if suspected of HIV. Conclusions. The study found a high level of HIV knowledge and positive attitude towards HIV patients. However, respondents also displayed negative attitudes and unacceptable practices probably due to fear. Training institutions need to ensure that students gain accurate knowledge on HIV especially on transmission routes to allay the fear of caring for HIV-infected patients.
Background . Mobile phones of health professionals can harbor various potential pathogens and become exogenous sources of infection for the patients, self, and family members. This study assessed the frequency and antimicrobial susceptibility pattern of bacteria from mobile phones of health care workers. Methods . In this crosssectional study a total of 58 health care professionals mobile phones were swabbed before and after decontamination with 70% alcohol and assessed for contamination with bacteria. Bacterial isolation, identification, and antimicrobial susceptibility test was done as per the standard procedures. Results . About 98% of the mobile phones assessed in this study were contaminated with bacteria. Coagulase negative Staphylococci, S. aureus , and E. coli were the most frequently isolated bacteria. Decontamination with 70% alcohol significantly decreased the rate of contamination from 98.3% to 55.2% (χ2=30.17;P-value<0.0001). About 17% of the isolates were resistant to two drugs. Conclusion . Appropriate infection prevention measures should be taken to minimize the risk that could be associated with mobile phones since the rate of contamination was high. Decontamination with 70% alcohol was effective in minimizing bacterial contamination of mobile phones so it should be used as a decontaminant agent for these apparatuses.
Although work environment conditions have improved much in the last decades, occupational exposures to chemicals and air pollutants still cause adverse health effects. The risk perception of occupational exposures to hazardous substances and the motivations for it have been investigated through a questionnaire study. These results have also been compared to previous studies performed by the largest trade union confederation in Sweden in 1975. In the current survey, 30% of the respondents believe to be at risk, 48% not, and 22% state to be unsure. The proportion of persons experiencing to be at risk due to exposures to chemicals or air pollution at work is unexpectedly similar to that of 1975. The explanations offered for the risk perception were in many cases vague and of a subjective nature, but again results are similar to those of 1975. References to more solid justifications such as performed exposure measurements or medical health checks are scarce, with the latter case being as scarce today as in 1975. There are only a few indications that a more systematic management of work environment issues has developed at Swedish workplaces; for instance, managers were more commonly stated as a source of information in 2011 than in 1975.
This study investigated the management of biomedical pollutants in the Accra Metropolitan Area in Ghana, using a qualitative case study approach involving interviews, focus-group discussions, and observation techniques. A state of precariousness was found to characterize the management of biomedical pollutants in the study area, culminating in the magnification of risks to the environment and public health. There is neither a single sanitary landfill nor a properly functioning incineration system in the entire metropolis, and most of the healthcare facilities surveyed lack access to suitable treatment technologies. As a result, crude burning and indiscriminate dumping of infectious and toxic biomedical residues were found to be widespread. The crude burning of toxic biomedical pollutants was found to provide environmental pathways for carcinogenic substances. These include polynuclear aromatic hydrocarbons (PAHs), polychlorinated dibenzofurans (PCDFs), polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated biphenyls (PCBs), hydrogen, lead, mercury, cadmium, chlorobenzenes, particulate matter, and chlorophenols. The improper disposal of biomedical pollutants in open dumps and unsanitary landfills also carries a risk of providing environmental entry points for volatile organic compounds (VOCs), inorganic macrocomponents, heavy metals, and xenobiotic organic compounds.
Objective. To investigate the circumstances associated with medication-related deaths. Design and Setting. This retrospective study investigated closed claims concerning medication-related deaths from 1996 to 2008 registered by the Danish Patient Insurance Association (DPIA). Results. A total of 80 were patients registered as having died because of an adverse event or error associated with a medication, and 37 of these cases were considered to have been preventable. The circumstances of the 37 deaths are described in detail in this report. Orthopaedic surgery, anaesthesiology, and internal medicine were the specialties involved in the majority of the deaths. Incorrect dosing was the cause of 17 deaths, and the use of the wrong drug caused 11 deaths. The administration of a drug despite a known allergy/intolerance or contraindication caused 6 deaths. Other 5 deaths were caused by anticoagulation medications. Methotrexate given daily by mistake caused 2 deaths. Conclusion. This study describes the circumstances of 37 preventable deaths caused by medication. Drug administration despite a known allergy, opioids, sedative, anticonvulsive medicine, and incorrect dosing and incorrect use of anticoagulants are the most important areas to be addressed in the development of future patient safety measures to reduce patient deaths caused by or related to medications.
Eruptive activity at the Kīlauea volcano (Hawai`i, USA) has increased since 2008 resulting in volcanic air pollution (vog) at levels exceeding the national air quality standard for sulfur dioxide. Previous investigations during lower vog levels found adverse cardiorespiratory effects in the residents. The purpose of this 2012 survey was to reassess and compare the impact of the increased volcanic activity on population health. Prevalence of cardiorespiratory signs, symptoms, and diseases was estimated in vog exposed and unexposed communities, and descriptions of perceived health and environmental effects were collected door-to-door. Vog exposure was significantly associated with increased odds of self-reported cough, phlegm, rhinorrhea, sore/dry throat, shortness of breath, sinus congestion, continual wheezing, eye and skin irritation, and diagnosed hypertension. Field measurements identified significantly higher average systolic and diastolic blood pressures (P=0.045,0.002) and lower blood oxygen saturation (P=0.008). Half of the participants perceived that Kīlauea’s intensified eruption had negatively affected their health with reports of financial impacts from degradation of agriculture and livestock. Relatively stronger magnitudes of health effects were associated with the higher exposure to vog. Public concerns remain about attributed effects of the ongoing eruption. Enhanced public health efforts are recommended at Kīlauea and other degassing volcanoes worldwide.
The Ostrava Region in the Czech Republic is a heavily polluted industrial area. Concentrations of PM10, PM2.5, and benzo[a]pyrene (B[a]P) significantly exceed limit values. To investigate the impact of these levels on human health, epidemiological, molecular epidemiology, and in vitro studies were done in 2008–2011. Morbidity of children was followed in 10 pediatric districts. In the most polluted district, children suffered higher incidence of acute respiratory diseases in the first year of life, and higher prevalence of asthma bronchiale. Gene expression was studied in children from Ostrava and from a control rural area. Genes specific to asthma bronchiale differed, suggesting a different molecular phenotype in children in the polluted region compared to children in the control area. A molecular epidemiology study showed adverse effect of the Ostrava exposures, but also an increased expression of XRCC5, which probably protects these exposed subjects against the degree of genetic damage that would otherwise be expected. In vitro studies clearly related concentration of B[a]P from PM2.5 extracts to induced PAH-DNA adducts. These studies clearly demonstrate that under the present local environmental conditions, the health of the population is severely impaired and will likely remain so for a significant period of time.
Background . Ambient air pollution is a recognized risk factor for multiple health conditions. For some health problems, the impact of air pollution is particularly evident to the patients in a specific age range. Nonsimultaneous exposures to two or more air pollutants may have different relationships with health outcomes than do simultaneous exposures. Methods . Case-crossover technique was used to analyze data on emergency department (ED) visits for ischemic heart disease (IHD), epistaxis, and upper respiratory infection (URI). Conditional logistic regression models were used to estimate odds ratios and their 95% confidence intervals corresponding to an increase in an interquartile range of air pollutant concentrations. Results . The results for IHD show that for older patients (age 60+ years), the association between sulphur dioxide (SO 2 ) exposure and IHD is weak. For ED visits for epistaxis (O 3 and SO 2 in one model) and URI (O 3 and NO 2 in one model), air pollutants lagged differently in the common model indicated significant statistical associations but not for common lags. Conclusion . The study findings, based on analyzed examples, suggest that (i) IHD cases in older age are less related to air pollution and (ii) air pollutants may affect some health conditions by a specific sequence of exposure occurrences.
Background. Nutrition during adolescence plays an important role in the individual’s life. Socioeconomic status, age, sex, and mothers’ educational level are among the important determinant factors of nutritional status of adolescents. In this study, we test the competing hypotheses about the correlates of nutritional status among Ethiopian adolescents. Methods. We report a total of 2084 adolescents and univariate and multivariable linear regression were used to assess socioeconomic factors associated with underweight and stunting among adolescents. Results. Age, highest grade completed, job, and last attended in community school were positively associated with BMI for Age z-score and highest grade completed, household income, and job were positively associated with Height for Age z-score. However, male gender was negatively associated with BMI for Age z-score and male gender, last attended in community school, abdominal pain, and household size were negatively associated with Height for Age z-score. Conclusion. Age of the adolescents, gender, educational status, employment status, and type of last school attended are associated with underweight; gender, place of residence, household size, household income, educational status, employment status, type of last school attended, and abdominal pain are associated with stunting. The findings reflect socio-economic characteristics are associated with underweight and stunting.
Climate change is an emerging challenge to the mental health of entire humanity. Several studies, in recent times, have brought to light the adverse public mental health outcomes of extreme weather events for the suffering communities. The general public and the policy making bodies need to gain awareness about these impacts. Through such awareness, communities and their governments can institutionalize mechanisms to provide psychological support to the populations affected by climate change, before it becomes a massive public health challenge and starts affecting the social and vocational lives of people. There is an urgent need for addressing these impacts. The aim of this paper is to provide an overview of the deleterious effects of climate change related extreme weather events on mental health, the worldwide response of several communities to such events, and preparedness of the public and government to deal with these adverse mental health impacts. Policy imperatives to prevent and mitigate these impacts have been suggested. It is hoped that the psychologists, governments, and communities will act earnestly to prevent the impending harm to human mental health due to climate change.
Clinical trials industry has seen a phenomenal increase in last ten years or so, and India has emerged as one of the foremost global destinations for clinical trials. Changed intellectual property regimen after WTO has been the prime mover of the phenomenon, and maximizing profits rather than serving any altruistic motives forms the main ideological underpinning of the rise of clinical trial industry in India. The paper examines the ideological underpinnings of the rise of clinical trials industry in the country in detail and how the ruling classes of India have tried to capitalize on this as a great economic opportunity. In the process the interests of India’s poor have been the main casualty.
Complementary and alternative medicine (CAM) is widely used among patients with hypertension. This study aimed to determine the use of CAM in community-dwelling individuals with hypertension. A cross-sectional questionnaire survey was administered to 318 hypertension patients to examine prevalence and patterns of CAM use; the use of CAM, specifically for treatment of hypertension or other conditions, and perceived effectiveness of CAM were examined. CAM use in the last 12 months was reported by 236 (74.2%) participants. Only 13.1% of these CAM users reported using CAM to treat hypertension. CAM users did not differ statistically from non-CAM users by age, marital status, health status, duration of hypertension, income, or education. Females showed a significantly higher prevalence of CAM use than that of males (OR 1.82, 95% CI 1.09, 3.11). Family/relatives, doctors, and patients themselves were the three main sources of information about CAM. More than 70% of responses were able to perceive the effectiveness of alternative medical systems, mind-body medicine, and manipulative/body-based therapies. There was a high prevalence of CAM use among hypertension patients, although the majority of CAM use was not specifically for hypertension. Further research is needed to assess the safety and efficacy of diverse CAM.
In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. Baby born with a weight less than 2,500 g is considered low birth weight, since below this value birth-specific infant mortality begins to rise rapidly. In Bangladesh, the prevalence of low birth weight is unacceptably high. Infant's sex differences, birth to conception interval, gestational age, and Apgar score are associated with infant birth weight. To screen low-birth-weight babies, simple anthropometric parameters can be used in rural areas where 80–90% of deliveries take place. A sample of 343 newborn singletons, 186 male and 157 female babies, were studied in Southwest region of Bangladesh to examine the birth weight status of newborns and to identify the relationship between birth weight and other anthropometric parameters of newborns. The mean birth weight was 2754.81±465.57 g, and 28.6% were low-birth-weight (<2,500 g) babies. All key anthropometric parameters of the newborns significantly correlated with infant birth weight (P=0.05). Mid upper arm circumference and chest circumference were identified as the optimal surrogate indicators of LBW babies. In the community where weighing of newborns is difficult, these measurements can be used to identify the LBW babies.
Analyses on the absorption of aluminium by rice boiled in distilled water in a variety of containers, such as old and new aluminium pots, clay receptacles, stainless steel pots, and steel pots, were carried out. 10 g of rice was taken as a representative sample. Colorimetric analysis of classical methods was used to determine the concentration of aluminium. The control for aluminium was 350 ± 130 μg/g. The new aluminium pots had a concentration of 126 ± 64 μg/g, old aluminium pots had 314 ± 128 μg/g, new clay pots had 132 ± 68 μg/g, old clay pots had 195 ± 137 μg/g, new steel pots had 241.00 ± 200 μg/g, old steel utensils had 186.83 ± 75.18 μg/g, new stainless steel utensils had 294.83 ± 163 μg/g, and old stainless steel utensils had 289.00 ± 75.155 μg/g. Aluminium leaching was detected in all forms of new and old cooking utensils, and leaching was below and within the control concentration range. Old aluminium pots had the highest concentration of leaching while new steel pots had the least leaching of aluminium. However, the aluminium contamination of the foods tested was insufficient to constitute a hazard to health.
High-volume horizontal hydraulic fracturing of shale formations has the potential to make natural gas a significant, economical energy source, but the potential for harm to human health is often dismissed by proponents of this method. While adverse health outcomes of medical conditions with long latency periods will not be evident for years and will depend on the exposure, duration of exposure, dose, and other factors, we argue that it would be prudent to begin to track and monitor trends in the incidence and prevalence of diseases that already have been shown to be influenced by environmental agents. The dirty downside of modern, unconventional natural gas development, as well as the potential for harm, is discussed.
